JP2002017877A - Medical energy irradiator - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical energy irradiator capable of eliminating a burden on a medical staff at the time of reuse while securing the function and the performance of the illuminator all the time by making a long-length main body easily exchangeable in simple structure. SOLUTION: The medical energy irradiator consists of an on-hand operation part incorporating a motor 63 and an insertion part which is freely attachable and detachable to/from the insertion port of the on-hand operation part and which is provided with a main body to be inserted to a living body. When the insertion part is mounted to the on-hand operation part and a hook 67 is moved back and forth by the motor 63, the hook 67 is fitted automatically into the narrow part 82 of this engaging member 80, climbing over the tapered part 81 of an engaging member 80 attached on an optical fiber 107.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a part for inserting an insertion part into a living body cavity or a lumen such as a gastrointestinal tract such as a blood vessel, an esophagus and a rectum, a urethra, an abdominal cavity, etc. After pressing or pressing against the body surface, the tissue such as the laser beam, microwave, radio wave, ultrasonic wave, etc. is irradiated to the living tissue from the emission part installed at the insertion part or the pressing part. The present invention relates to a medical energy irradiation device for treating tumors such as cancer, prostatic hyperplasia, and the like.

[0002]

2. Description of the Related Art A long shaft-shaped main body is inserted into a living body cavity or a small incision is made in the living body, and the energy emitting portion included in the distal end of the main body is used to reach a lesion site in the living body. There is known a medical energy irradiation apparatus for irradiating energy such as a laser beam to heat, degenerate, necrotic, coagulate, cauterize or evaporate a tissue to reduce or eliminate the tissue, thereby treating the tissue.

For example, in the treatment of benign prostatic hyperplasia, since the prostate is located at the bottom of the bladder at the position surrounding the proximal end of the urethra, a medical energy irradiation device for transurethral treatment using laser light or the like is used. Is commonly used.

[0004] As an apparatus for treating such prostatic hypertrophy, for example, after inserting a long main body into the urethra, the laser emitting section is reciprocated in the longitudinal direction in the main body, and the laser light emitting angle is adjusted. There has been proposed a medical energy irradiation apparatus in which laser light is focused on a target portion located deep in a living tissue by changing the energy. As a result, only the target site is heat-treated to a desired temperature, and sites other than the target site are kept at a low temperature.

[0005]

However, for example, the above-mentioned conventional medical energy irradiation apparatus has a long main body inserted into a living body, and a driving unit for reciprocating a laser emitting unit in the main body. Is a relatively large-scale device configuration in which the above is combined. For this reason, in general,
The long body once used for treatment is washed and sterilized and then repeatedly used for a plurality of patients.

Therefore, there is a problem that the function and performance of the device are reduced with time due to repeated use, and a desired and sufficient therapeutic effect may not be obtained. In addition, there is a problem that it is extremely burdensome for a medical practice to completely clean and sterilize in order to eliminate the risk of infection.

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problems of the prior art, and an object of the present invention is to make it possible to replace a long body with a simple structure so that the function and performance of the apparatus can be improved. It is an object of the present invention to provide a medical energy irradiating apparatus capable of always maintaining the above-mentioned condition and eliminating the burden on the medical site due to reuse.

[0008]

The object of the present invention is achieved by the following means.

(1) A medical energy irradiation apparatus for irradiating a living tissue with energy for treatment, which is provided in a long body and movably provided in a distal end portion of the main body, and is provided from a base end side. An energy emitting portion for emitting energy to be applied, a power transmission member movably installed in the main body, and the energy emitting portion attached to the tip, and a drive for reciprocating the power transmission member in a longitudinal direction of the main body. Means, wherein the power transmission member is provided with a first engagement member for receiving a driving force by the driving means, and the driving means is detachably engaged with the first engagement member. An energy irradiating device for medical use, wherein a second engaging member is provided.

(2) One of the first and second engaging members has a hook provided with a substantially U-shaped groove, and the other has a concave neck into which the substantially U-shaped groove is fitted. And a guide portion formed adjacent to the constricted portion and formed in a tapered shape for guiding the substantially U-shaped groove of the hook to the constricted portion. The medical energy irradiating device includes the substantially U-shaped groove. The medical energy irradiation device according to the above (1), further comprising a regulating unit that regulates the movement of the first engagement member when guiding to the constricted portion.

(3) The medical device according to the above (1) or (2), wherein an energy transmission member for transmitting energy transmitted from a proximal end side of the main body to a distal end side also serves as the power transmission member. Energy irradiation equipment.

(4) It is preferable that the first engagement member has a casing having a support portion that is reciprocally supported, and the energy transmission member is housed in the casing in a loop. The medical energy irradiation device according to the above (3), which is characterized in that:

(5) The medical energy irradiation apparatus according to any one of (1) to (4), wherein the energy is a laser beam.

[0014]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the present invention will be described below in detail with reference to the accompanying drawings.

FIG. 1 is a perspective view showing a laser irradiation apparatus according to an embodiment of the present invention, FIG. 2 is a perspective view seen from the rear left of FIG. 1, and FIG. FIG. 4 is a cross-sectional view for explaining the structure, FIG. 4 is a perspective view showing the tip of the laser irradiation device cut along a vertical plane, and FIG.
FIG. 3 is a perspective view of the right side of FIG. For convenience of explanation,
In FIG. 4, the movable parts are omitted, and in FIG. 5, members that cover the outside are omitted.

The laser irradiation apparatus 10 shown in FIGS.
Reference numeral 0 denotes a side-projection type laser irradiation device that irradiates a living tissue with laser light and is used for, for example, treatment of prostatic hypertrophy. The laser irradiation device 100 includes an insertion unit 10 including a long shaft-shaped main body 101 inserted into a living body,
The laser emitting unit 112 included in the main body 101 is
1 and a hand portion 50 provided with a driving means for reciprocating in the longitudinal direction, and both are detachable as described later.

The main body 101 of the insertion section 10 has a window 150 at an end thereof, which is an opening for transmitting a laser beam.
The whole body 101 including the window 150 is covered with the cover 104 having good laser light transmission. The tip of the main body 101 is sealed with a cap 143. Cap 1
43 is provided with a front observation window 145 for observing the front when the main body 101 is inserted into a living body. In the front observation window 145, for example, a light transmitting plate 148 having good light transmittance is fitted and fixed. A wall member 151 that defines an internal space is fixed inside the distal end portion of the main body 101. The wall member 151 is composed of a pair of left and right two parts.

An optical fiber 107 for transmitting a laser beam is arranged inside the main body 101. Optical fiber 10
7 is covered by a stainless steel protective pipe 108 in the main body 101 except for a tip portion so as not to be damaged or bent. The proximal end of the optical fiber 107 is connected to a laser light generator (not shown) via an optical connector.

A laser emitting section 112 for reflecting the laser light to the side is connected to the tip of the optical fiber 107.

In FIGS. 3 and 4, reference numeral 122 denotes
The lumen through which the optical fiber 107 covered by the protection pipe 108 is inserted so as to be able to reciprocate. Lumen 12
2 is formed in parallel with the axis of the main body 101, and an O-ring (not shown) for sealing between the protective pipe 108 and the lumen 122 is provided on the base end side to prevent leakage of cooling water. Can be Reference numeral 123 denotes a lumen through which the endoscope 124 is movably inserted.

The endoscope 124 is inserted from the base end side of the laser irradiation apparatus 100 shown in FIG. 1, and is installed inside the main body 101 so as to be movable in the longitudinal direction. As the endoscope 124, for example, one having an optical fiber bundle and a protective tube, provided with an imaging lens (not shown) at the tip, or one provided with a relay lens in a metal pipe may be used. it can. In any case, it is desirable to use one with a light guide for illumination light. The endoscope 124 has a field of view suitable for obtaining an observation field from both the window 150 and the front observation window 145. Therefore, the endoscope 124 allows observation of the surface of the living tissue irradiated with the laser beam through the window 150 or the front observation window 145, positioning of the distal end of the main body 101 based on the endoscope observation, and visualization of the laser irradiation position. Confirmation can be performed.
Further, since the irradiation surface can be continuously observed during the irradiation of the laser beam, the irradiation conditions can be optimized based on the actual state.

The cooling water circulates through the main body 101 to cool the surface of the living tissue receiving the laser beam, the laser emitting end and the reflecting portion in the distal end of the main body 101, and the like. The cooling water is
The main body 101 is circulated by a cooling liquid circulating device (not shown).
The cooling water flows into the cooling water injection tube 105 and flows out of the cooling water discharge tube 106.

As shown by arrows in FIGS. 4 and 5, the cooling water supplied from the cooling water injection tube 105 (FIG. 2) is supplied to the cooling water inflow lumen 1 provided in the main body 101.
25, a part of which flows from the oblong window 152 formed in the wall member 151 to the laser emitting portion 1.
12 flows into the moving internal space. The rest goes around to the tip as it is. In addition, another elliptical window is not formed in another wall member. Thereafter, the two are integrally returned via a cooling water outflow lumen (not shown) provided at a position symmetrical to the cooling water inflow lumen 125 and a cooling water discharge tube 106.

The washing water supplied from the washing water tube 141 (FIG. 2) passes through the washing water lumen 142,
After flowing toward the distal end side and being bent toward the front observation window 145 by the flow path 144 formed in the cap 143,
It flows so as to wash the outside of the light transmitting plate 148 provided in the front observation window 145. It is desirable to provide a check valve (not shown) at the base end of each of the lumens 125, 142 and the like in order to prevent backflow of the cooling water and the washing water.

At the ends of the cooling water injection tube 105, the cooling water discharging tube 106, and the washing water tube 141, connectors (not shown) for connecting these together are attached. Reference numeral 147 in FIGS. 1 and 2 denotes a power cord.

FIG. 6 is a perspective view showing the details of the laser emitting portion connected to the tip of the optical fiber. As shown in FIG. 6, the laser emitting unit 112 rotates around a hinge shaft 117 around a fixing member 114 fixed near the tip of the optical fiber 107 and a pair of arms 116 extending from left and right side surfaces of the fixing member 114. Laser reflecting means 113 movably connected. Therefore, the optical fiber 10
Since the laser 7 and the laser emitting unit 112 move integrally, the relative positional relationship between the tip of the optical fiber 107 and the laser reflecting means 113 is kept substantially constant. Therefore, the spot diameter of the emitted laser light can be stabilized without using a special optical system, and the structure of the device is simple,
Easy to manufacture and less likely to break down.

The laser reflecting means 113 includes an optical fiber 1
There is provided a reflection surface 119 for reflecting the laser light emitted from the reference numeral 07. As the reflection surface 119, a metal film such as gold is adhered, vapor-deposited or plated, or A is formed on the reflection surface of the metal film.
High refractive index dielectric materials such as l ₂ O ₃ , ZrO ₂ , TiO ₂ and CeO ₂ and low refractive index dielectric materials such as MgF ₂ and SiO ₂ were laminated by alternately depositing a plurality of layers. A dielectric multilayer film is preferably used.

The fixing member 114 is slidable between a pair of wall members 151 in the main body 101. Pins 118 are slidably engaged with guide grooves 153 formed on the wall member 151 at both ends of the laser reflecting means 113.

The guide groove 153 is, as shown in FIG.
It has a reciprocating sliding portion 153a that is non-parallel to the axial direction of the main body 101. The reciprocating sliding portion 153a is formed so as to be farther from the window 150 toward the proximal end and closer to the window 150 toward the distal end. Have been.

FIG. 7 is a diagram schematically showing the path of the laser beam when the laser reflecting means is located at the distal end position P1, the intermediate position P2, and the proximal end position P3 during the reciprocating movement. As shown in FIG. 7, the laser reflecting means 113
During the reciprocating movement, the main body 10 is located at the tip position P1.
The laser beam stands up in a direction almost perpendicular to the axial direction of the first laser beam, and reflects the laser beam at a small reflection angle. When the laser reflecting means 113 is located at the base position P3, the laser reflecting means 113 is inclined in a direction almost parallel to the axial direction of the main body 101, and reflects the laser light at a large reflection angle. Therefore, when the laser reflecting means 113 reciprocates while changing the tilt angle, the emission position of the laser light always moves, and the optical axis of the laser light always concentrates on the target portion 121 in the living tissue 120.

In this embodiment, the guide groove 153 with which the pin 118 of the laser reflecting means 113 is slidably engaged is
In addition to the reciprocating sliding portion 153a in a range required for the reciprocating motion of the laser reflecting means 113 by the driving means described above, as shown in FIG. 3, the reciprocating sliding portion 153a is formed to extend from the reciprocating sliding portion 153a to the base end side. Extension part 153b and reciprocating sliding part 15
Substantially S-shaped connecting portion 15 connecting the extension 3a and the extension 153b
3c.

FIG. 8A is a diagram showing the position of the laser reflecting means during laser irradiation, and FIG. 8B is a diagram showing the position of the laser reflecting means during forward observation. FIG.
As shown in (A), at the time of laser irradiation, the laser reflecting means 113 is engaged with the reciprocating sliding portion 153a of the guide groove 153. On the other hand, as shown in FIG.
When performing forward observation with the laser reflecting means 113
Is engaged with the extension 153b of the guide groove 153. Thereby, at the time of forward observation, the energy reflecting means 113
It is further inclined and retracted (for example, substantially horizontally) toward the axis of the main body 101 than when it is engaged with the reciprocating sliding portion 153a and retracted. Therefore, the distal end of the endoscope 124 is
It can be pushed into the endoscope receiving space 146 formed at the distal end of the device 1 to observe the front thereof. Since the connecting portion 153c is formed in a substantially S-shape, it becomes possible to guide the energy reflecting means 113 to the extending portion 153b and to incline it substantially horizontally with a small stroke.

FIG. 9 is a perspective view schematically showing an internal structure in which an insertion portion is attached to a hand, FIG. 10 is a perspective view seen from the rear left of FIG. 9, and FIG. 11 is a perspective view of the hand. FIG. 12
Is a side view for explaining an interlocking mechanism between the laser reflecting means operating section of the hand section and the endoscope operating section, and FIG. 13 is a perspective view of the insertion section.

In the present embodiment, as described above, the insertion section 10 and the hand section 50 are configured to be detachable. As shown in FIGS. 9 and 10, a motor 63 is provided in the hand portion 50, and a bevel gear 66 provided on a cam 65 is meshed with a bevel gear 64 provided on a drive shaft of the motor 63. ing. A hook 67 is connected to the cam 65 via a link mechanism 61. Therefore, when the motor 63 is driven, the hook 67 is moved through the bevel gears 64 and 66, the cam 65 and the link mechanism 61,
The guide member 68 is reciprocated in the groove 68a.

A compression spring 69 is attached to the hook 67. The compression spring 69 allows the hook 67
Is urged toward the insertion portion 10 and is engageable with an engagement member 80 described later fixed to the optical fiber 107. Note that the hook 67 is connected to the stopper 6 of the guide member 68.
8b regulates the movement to the insertion portion 10 side.

As shown in FIG. 11, a hand portion 50 includes a mounting portion 51 to which the insertion portion 10 is directly mounted, and a laser slidably provided above the mounting portion 51 via a groove engaging portion 54. It comprises a reflector operating section 52 and an endoscope operating section 53 slidably provided below the mounting section 51 via a groove engaging section 55.

The mounting portion 51 of the hand portion 50 has an insertion portion 10
The insertion opening 70 into which the is inserted is formed. Also, a tube insertion groove 71 for inserting the tubes of the insertion portion 10 is formed on one side of the attachment portion 51, and the body 101 of the insertion portion 10 is inserted on the other side of the attachment portion 51. The main body insertion groove 72 is formed. Further, an endoscope insertion portion 73 for inserting the endoscope 124 is formed on one side of the attachment portion 51.

A motor 63, bevel gears 64 and 66, and a cam 65 are housed in the laser reflecting means operating section 52 of the hand section 50. Link mechanism 61 connected to cam 65
Extends into the mounting portion 51, and the hook 67 provided at the tip of the link mechanism 61 is engaged with the groove 68a of the guide member 68 provided in the mounting portion 51 as described above. . Therefore, the laser reflecting means operating section 52
By sliding with respect to the mounting portion 51,
The laser reflecting means 113 provided at the tip of the optical fiber 107 can be moved in the longitudinal direction of the main body 101 via the hook 67 and the engaging member 80 fixed to the optical fiber 107.

A supporting portion 56 for supporting the endoscope is provided on the rear end side of the endoscope operating portion 53 of the hand portion 50. The endoscope 124 is inserted into the main body 101 of the insertion section 10 through the endoscope insertion hole 57 formed in the support section 56, and then fixed to the support section 56 by a fixing member (not shown). Therefore, the endoscope 124 can be moved in the longitudinal direction of the main body 101 by sliding the endoscope operation section 53 with respect to the attachment section 51.

As shown in FIG. 12, a pin 118 of the laser reflecting means 113 is connected to the reciprocating sliding portion 153 from the extended portion 153b of the guide groove 153 at the proximal portion 50 of the present embodiment.
a, the endoscope 124 is retracted to the base end side of the main body 101, and the pin 118 of the laser reflecting means 113 is moved from the reciprocating sliding portion 153a of the guide groove 153 to the extension 153.
An interlocking mechanism configured to move the endoscope 124 to the distal end side of the main body 101 along with the movement of b is provided. The interlocking mechanism includes a pin 8 provided on the mounting portion 51.
5 is provided with a lever 86 rotatably attached thereto, and pins 87, 88 provided at both ends of the lever 86.
Are engaged with a groove 89 formed in the laser reflecting means operation section 52 and a groove 90 formed in the endoscope operation section 53, respectively. Therefore, when the laser reflecting means operating section 52 is pulled backward (to the right in FIG. 12), the endoscope operating section 53 connected to the pin 88 on the opposite side of the lever 86 moves forward (FIG. 1).
2 (left side in FIG. 2) (FIG. 12 (A)), and when the laser reflecting means operation unit 52 is pushed forward, the endoscope operation unit 53 is retracted (FIGS. 12 (B) and (C)). In order to facilitate the forward movement of the laser reflecting means operating section 52, the lever 8
It is also possible to provide a spring member (not shown) for applying an urging force for rotating the motor 6 in a counterclockwise direction in FIG.

Further, malfunction can be prevented by allowing the motor 63 to rotate only when the laser reflecting means operating section 52 and the mounting section 51 are integrated as shown in FIG. 12C. it can. Specifically, the mounting portion 51
A push-type switch 58 is provided at the most proximal end of the slide surface of the motor, and the motor 63 can be energized only when the switch 58 is pressed. The switch 58
As shown in FIG. 12 (C), when the laser reflecting means operating section 52 and the mounting section 51 are integrated, they are pushed. The switch 58 can be replaced with various sensors.

As shown in FIG. 13, the insertion section 10 has a base 74 to which the main body 101 is connected. A cooling water injection tube 105, a cooling water discharge tube 106, a cleaning water tube 141, an endoscope lumen 123, and an optical fiber 107 are attached to the base 74.

An engaging member 80 for engaging the hook 67 is fixed to the optical fiber 107. The engagement member 80 includes a pair of tapered portions 81, 81 as tapered guide portions, and a concave constriction 82 therebetween. On the other hand, the base portion 74 of the insertion portion 10 has a guide surface 75 as a support portion that slidably supports the engaging member 80 in the longitudinal direction of the main body 101, and a regulating plate 76 that regulates forward movement of the engaging member 80. Are provided. Thus, when the hook 67 is reciprocated by the motor 63, the hook 67 is pushed by the hook 67 and stopped by the regulating plate 76.
Gets over the tapered portion 81 and is automatically fitted into the constricted portion 82 of the engaging member 80. In addition,
The engaging member 80 provided on the optical fiber 107 needs to be brought to the regulating plate 76 side in advance in order to stop by contacting the regulating plate 76 by the reciprocating motion of the hook 67.

When the laser beam is emitted by reciprocating the optical fiber 107, the reciprocating motion of the hook 67 by the motor 63 is applied to the optical fiber 107 via the fitting structure of the hook 67 and the constricted portion 82. The transmission is ensured.

As shown in FIGS. 9 and 13,
The optical fiber 107 is accommodated in the base 74 of the insertion section 10 in a loop shape. Thereby, when the optical fiber 107 reciprocates, this loop-shaped portion
It can serve as a headroom for reciprocation.

Next, the specific use situation and operation of the laser irradiation apparatus 100 will be described.

When using the laser irradiation apparatus according to the present embodiment, first, the base 74 of the insertion section 10 is fitted to the insertion opening 70 formed in the attachment section 51 of the hand section 50. Then, the hook 67 is reciprocated by the motor 63 in the hand section 50. As a result, the hook 67 gets over the tapered portion 81 of the engaging member 80 provided on the optical fiber 107 and automatically fits into the constricted portion 82 of the engaging member. Therefore, the hook 67 on the hand 50 side,
The engaging member 80 provided on the optical fiber 107 on the insertion section 10 side is firmly fixed.

That is, by the fitting structure of the hook 67 and the constricted portion 82, the insertion portion 10 is easily and securely mounted on the hand portion 50, and the reciprocating driving force of the motor 63 is surely applied to the optical fiber 107. It becomes possible to communicate. Thereby, the relatively expensive manufacturing hand portion 50 housing the driving mechanism such as the motor 63 can be reused, while the relatively low manufacturing cost insertion portion 10 made of the optical fiber 107 and the resin component can be used. It can be easily replaced by discarding after each use.

Therefore, the insertion section 10 provided with the main body 101 and the like in which the laser emission section 112 is installed is always new, so that the functions and performance of the apparatus can be always secured. Moreover, by discarding the inserted portion 10 inserted into the living body at the time of treatment after use, it is possible to save the trouble of sterilization treatment for eliminating the risk of infection due to reuse.

When the insertion portion 10 is attached to the hand portion 50, the hook 67 reciprocates and is automatically fitted into the constricted portion 22, even if the hook 67 is at the approximate position.
As the motor 3, it is possible to use an inexpensive small motor without using a motor having a high positional accuracy or the like, and it is also possible to reduce the size and weight of the hand 50, and thus to operate the laser irradiation device. The performance is improved.

For example, in the treatment of benign prostatic hyperplasia,
As shown in FIG. 7, the main body 101 is inserted into the urethra from the distal end, and the distal end of the main body 101 is positioned near the lesion area, that is, the irradiation target portion 121 of the living tissue 120 that is the prostate tissue. At the time of this positioning, it is desirable to directly confirm the position of the distal end of the main body 101 with the endoscope 124.

At this time, as shown in FIG. 12A, the laser reflecting means operation section 52 of the hand section 50 is pulled backward, and the endoscope operation section 53 is moved forward. As a result, the pins 118 of the laser reflecting means 113
The endoscope 124 moves to the distal end side of the main body 101 as it moves from the third reciprocating sliding portion 153a to the extension portion 153b. By operating the laser reflecting means 113 with the extended portion 153b of the guide groove 153 by the operating portions 52 and 53 in this manner, the laser reflecting means 113 can be inclined and retracted so as to be substantially horizontal along the axis of the main body 101. Thus, not only is the laser reflector 113 not obstructing the front view of the endoscope 124, but also the tip of the endoscope 124 can be moved to the far side of the tip of the main body 101 without interfering with the laser reflector 113. 8, it is possible to observe the front, which is the insertion direction of the main body 101, in more detail (FIG. 8).
(B)). Therefore, the tip of the main body 101 can be positioned more accurately in the living body. Further, even within the main body 101 having a limited diameter, it is possible to use an endoscope having a large diameter capable of securing a clear and wide field of view. Therefore, the positioning of the distal end of the main body 101 and the observation of the surface of the living tissue at the time of laser light irradiation can be performed more smoothly, and accurate laser light irradiation is realized.
It is possible to reduce the burden on the patient due to the shortened treatment time. Further, the laser reflecting means 113 and the endoscope 12
Since the mechanism for interlocking the front and rear movements of the laser reflecting means 113 with each other in the direction toward the distal end in the main body is adopted, it is ensured that the laser reflecting means 113 and the endoscope 124 may interfere with each other by mistake. Can be prevented.

In this way, the front observation window 145 and the window 150
While observing the living tissue surface layer with the endoscope 124 through
By moving the entire laser irradiation apparatus 100 in a predetermined direction (longitudinal direction of the main body 101) or manually rotating the entire laser irradiation apparatus 100, the distal end of the main body 101 on which the laser emitting section 112 is installed and the target portion 121. And position adjustment.

Next, a cooling liquid circulation device (not shown) is operated to circulate cooling water in the laser irradiation device 100.
Specifically, the cooling water flows into the distal end portion of the main body 101 via the cooling water injection tube 105 and the inflow lumen 125, and the components that generate heat by the laser beam and the cover 10.
The surface of the living tissue that is in close contact with 4 is cooled.

When the above operations are completed, FIG.
(B) As shown in (C), the laser reflecting means operating unit 52 of the hand unit 50 is pushed forward, and the endoscope operating unit 53 is pressed.
Retreat. Accordingly, as the pin 118 of the laser reflecting means 113 moves from the extending portion 153b of the guide groove 153 to the reciprocating sliding portion 153a, the endoscope 124 retreats to the side opposite to the distal end side of the main body 101. At this time, after the endoscope 124 is fully retracted and the laser reflecting means 113 is still engaged with the extension 153b (FIG. 12B), the laser reflecting means operating section 52 is further pushed forward. Thereby, the laser reflecting means 113 is engaged with the reciprocating sliding portion 153a (FIG. 12C,
FIG. 8 (A)).

Next, after rotating the motor 63, a laser light generator (not shown) is operated. The laser light output from the laser light generating device is guided by the optical fiber 107 and the laser reflecting means 11 of the laser emitting unit 112.
The light 3 is reflected to the side, exits from the window 150, and irradiates the target portion 121. At this time, the laser reflecting means 113 changes the reflection angle while reciprocating at a period of about 0.1 to 10 Hz in the axial direction, so that the optical path axis of the laser light is continuously changed. Part 12
Cross at 1.

As a result, the target portion 121 inside the living tissue 120 and its vicinity are heated by the irradiated laser beam and reach a desired temperature. On the other hand, the irradiation amount of the laser beam to a region above the target portion 121 in FIG. 7, that is, an area near the laser irradiation device 100, for example, an arbitrary point on the surface layer of the living tissue 120 is small, and the generated heat amount is small. Similarly, the amount of laser light irradiation on a region farther than the target portion 121 in FIG. 7 is small, and the amount of generated heat is small. Therefore, the peripheral area of the target portion 121 is
Maintained at a relatively low temperature and protected from the effects of laser light. Next, the position of the target part 121 is changed,
Laser light is applied. By repeating this process, the regions to be treated at a plurality of locations are heated.

The laser beam used in the laser irradiation apparatus 100 of the present embodiment is not particularly limited as long as it has a depth of a living body, but the wavelength is 750 to 1300 nm.
Alternatively, a thickness of about 1600 nm to 1800 nm is preferable. Wavelengths of 750 to 1300 nm and 1600 nm to 1
Since the laser light of about 800 nm is particularly excellent in the depth of the living body, when the laser light is applied to the living tissue, the absorption of energy in the surface layer is small, and therefore, the laser light is more effectively applied to the deep part of the living tissue. Laser light can be applied to the target site (lesion site) located.

Examples of the laser light generator for generating the laser light having the above-mentioned wavelength include a gas laser such as a He-Ne laser, a solid laser such as an Nd-YAG laser, and a G laser.
Semiconductor lasers such as aAlAs lasers are exemplified.

As the constituent material of the main body 101, a hard pipe made of metal such as stainless steel is preferable. Further, as a constituent material of the wall member 151, for example, polyolefin such as polyethylene and polypropylene, ethylene-vinyl acetate copolymer (EVA), polyester such as polyvinyl chloride, polyethylene terephthalate and polybutylene terephthalate, polyamide, polyurethane and polystyrene , Polycarbonate, fluororesin, etc., and a polymer alloy containing one of these, or a combination of two or more of these.

The surface of the cover 104 may be coated with a hydrophilic polymer material or a lubricating coating such as silicon or fluororesin. Thereby, the friction of the body surface can be reduced, and the insertion into the body cavity can be made smooth.

The materials of the cover 104 and the light transmitting plate 148 are polyethylene terephthalate, quartz glass, acrylic, polystyrene, polycarbonate, polyethylene,
It is desirable to use a material having excellent light transmitting properties such as polypropylene, vinylidene chloride, Teflon (registered trademark), and polyester.

FIG. 14 is a perspective view showing a laser irradiation apparatus according to another embodiment of the present invention, and FIG. 15 is a perspective view of the insertion section shown in FIG. Hereinafter, points different from the above-described embodiment will be mainly described, and common members will be denoted by the same reference numerals and description thereof will be omitted.

In this embodiment, as shown in FIG.
The hand portion 50a has only one casing,
An operation unit operated by an operator to move the laser reflecting means 113 in the longitudinal direction of the main body 101 is not provided.
That is, the configuration in which the laser reflecting means 113 is retracted by engaging with the extension 153b of the guide groove 153 is omitted,
The overall structure is simple. On the other hand, as shown in FIG. 15, the base 74 of the insertion portion 10a is further provided with a regulating plate 77 for regulating backward movement in addition to a regulating plate 76 for regulating forward movement of the engaging member 80.

In this embodiment, when the hook 67 is reciprocated by the motor 63, the engaging member 80 is pushed by the hook 67 and stopped by either the regulating plate 76 or 77. The hook 67 gets over the tapered portion 81 and is automatically fitted into the constricted portion 82 of the engaging member 80. That is, the engaging member 80 is
The hook 67 can be automatically fitted into the constricted portion 22 if it is located between the hooks 77. Therefore,
When the insertion portion 10a is attached to the hand portion 50a, there is an advantage that it is not necessary to bring the insertion portion 10a to one side, for example, the regulation plate 76 in advance.

The embodiments described above are not described to limit the present invention, and various modifications can be made by those skilled in the art within the technical concept of the present invention.

For example, in the above-described embodiment, the tapered portions 81, 81 have a truncated cone shape. However, the present invention is not limited to this.
It may have a shape of a substantially half truncated cone cut along a plane parallel to the axis.

Although the laser light has been described as an example of the energy applied to the living tissue, the present invention is not limited to this. For example, energy such as microwaves, radio waves, and ultrasonic waves can be used. Irradiation may be performed.

Although the prostate has been described as an example of the living tissue to be subjected to the heat treatment, the present invention is not limited to this, and the present invention is not limited to this. Blood vessels, digestive tracts (esophagus, intestinal tract, etc.), abdominal cavity, etc. And all living tissues that can be subjected to heat treatment by radiating energy from within the body or from the body surface.

[0070]

As described above, according to the medical energy irradiating apparatus of the present invention, the relatively expensive parts containing the driving means such as the motor can be reused, while the relatively expensive parts can be reused. The portion provided with the long body having low manufacturing cost can be discarded for each use and easily replaced.

Therefore, since a long main body or the like in which the energy emitting section is installed is always used as a new one, the function and performance of the apparatus can be always ensured. Moreover, by disposing of the main body and the like that have been brought into contact with the living body during treatment after use, the burden on the medical site due to reuse can be eliminated.

Further, the hook provided with the substantially U-shaped groove is guided by a guide portion formed in a tapered shape and is engaged with the concave constriction, so that the first power transmission member is provided with the hook.
If the engaging member and the second engaging member provided on the driving means can be detachably engaged with each other, for example, only by reciprocating the hook by the driving means, the hook is in the approximate position. However, the hook and the constricted portion can be automatically engaged with each other, so that, for example, an inexpensive small motor can be used as the driving means, and the size and weight of the device can be reduced. Operability of the irradiation device is improved.

[Brief description of the drawings]

FIG. 1 is a perspective view showing a laser irradiation apparatus according to an embodiment of the present invention.

FIG. 2 is a perspective view of FIG. 1 as viewed from the rear left.

FIG. 3 is a cross-sectional view for explaining an internal structure of a tip portion of the laser irradiation device.

FIG. 4 is a perspective view showing a distal end portion of the laser irradiation device cut along a vertical plane.

FIG. 5 is a perspective view seen from the front right of FIG. 4;

FIG. 6 is a perspective view showing details of a laser emitting unit connected to the tip of the optical fiber.

FIG. 7 is a diagram schematically showing a path of a laser beam when the laser reflecting means is located at a distal end position, an intermediate position, and a proximal end position during a reciprocating movement.

8A is a diagram illustrating a position of a laser reflecting unit during laser irradiation, and FIG. 8B is a diagram illustrating a position of the laser reflecting unit during forward observation.

FIG. 9 is a perspective view schematically showing an internal structure in a state where an insertion portion is attached to a hand portion.

FIG. 10 is a perspective view seen from the rear left of FIG. 9;

FIG. 11 is a perspective view of a hand portion.

FIGS. 12A to 12C are side views for explaining an interlocking mechanism between a laser reflecting means operation unit and an endoscope operation unit at a hand.

FIG. 13 is a perspective view of an insertion portion.

FIG. 14 is a perspective view showing a laser irradiation apparatus according to another embodiment of the present invention.

15 is a perspective view of the insertion section shown in FIG.

[Explanation of symbols]

63: motor (drive means), 67: hook (second engaging member), 80: engaging member (first engaging member), 81: guide portion, 82: constricted portion, 75: guide surface (support portion) Reference numerals 76, 77: regulating means, 101: main body, 107: optical fiber (energy transmission member, power transmission member), 112: laser emission portion (energy emission portion).

 ──────────────────────────────────────────────────続 き Continued on the front page F term (reference) 4C026 AA04 BB04 BB07 BB08 DD03 DD06 FF17 FF34 FF43 FF53 FF58 4C060 EE03 EE15 EE19 JJ12 KK47 MM24 4C082 MA02 MC01 ME01 ME18

Claims (5)

[Claims] 1. A medical energy irradiation apparatus for irradiating a living tissue with energy for treatment, comprising: a long main body; movably installed in a distal end portion of the main body; An energy emitting unit for emitting energy, a power transmitting member movably installed in the main body, and the energy emitting unit attached to a tip, and a driving unit for reciprocating the power transmitting member in a longitudinal direction of the main body. The power transmission member is provided with a first engagement member that receives a driving force of the driving unit, and the driving unit can be detachably engaged with the first engagement member. A medical energy irradiation device comprising a second engaging member. 2. One of the first and second engaging members has a hook provided with a substantially U-shaped groove, and the other has a concave constricted portion into which the substantially U-shaped groove is fitted. And a guide portion formed adjacent to the constricted portion and formed in a tapered shape for guiding the substantially U-shaped groove of the hook to the constricted portion, wherein the medical energy irradiating device includes the substantially U-shaped groove. The medical energy irradiation device according to claim 1, further comprising a regulation unit that regulates movement of the first engagement member when guiding the first engagement member to the constricted portion. 3. The medical energy irradiation apparatus according to claim 1, wherein an energy transmission member that transmits energy transmitted from a proximal end side of the main body to a distal end side also functions as the power transmission member. . 4. The apparatus according to claim 1, wherein the first engaging member has a casing having a support portion supported so as to be able to reciprocate, and the energy transmitting member is housed in the casing in a form of a loop. The medical energy irradiation apparatus according to claim 3, wherein 5. The medical energy irradiation apparatus according to claim 1, wherein the energy is a laser beam.